Our House Grief Support Center

Photo Gallery Events Calendar 2012 Run For Hope

REGISTER FOR OUR HOUSE RUN FOR HOPE

This page only accommodates 1 registration at a time so each person can have a customized t-shirt. For multiple registrations, please follow the instructions after you press 'Submit & Continue to Checkout'.

If you have any questions, please contact Jessica at jessicak@ourhouse-grief.org / 310.473.1511
Please note: all input fields are required. Thank you.

first name last name

gender age

parent/guardian (if applicable) first name last name

email phone number

emergency contact

Please select one (1) from the following options:

I am registering for a child/teen ages 17 and under participating in the Run for Hope ($25)

I am an adult participating in the Run for Hope ($35)

I am participating in the adults only In Memory Walk ($35)

I'm unable to attend, but would like to make a donation

I'm unable to attend, but would like my special person's name on the Team OUR HOUSE T-shirt for $50

Participant Release
I agree (give permission for) myself and/or any child/ren I am responsible for to participate in the OUR HOUSE Run for Hope on Sunday, April 29th, 2012.  (In consideration of the foregoing, I, for myself, and my heirs, assigns, executors, administrators, and trustees, waive and release any and all rights and claims for any injuries and damages, including, but not limited to demands or actions for negligence, premises liability, emotional injury, intentional conduct, tort claims, and any other actions or demands of whatsoever nature that I have or may have against OUR HOUSE, Inc., its employees, agents, contractors, principals, directors, volunteers, sponsors, and representatives.)  I acknowledge that there are risks involved in these events and I voluntarily assume these risks.  I understand that my child/ren are not allowed to run beyond their assigned mile marker/finish line. I agree to assume responsibility for my child/ren during the entire event.  Should arrangements be made for another adult to serve as chaperone for my child/ren, I agree to provide OUR HOUSE with a signed statement indicating the name, relationship, and contact number (cell phone # preferred) for the chaperone.

By checking this box, and agreeing to the above disclaimer, you are providing us with a digital signature granting permission for OUR HOUSE to photograph you/your child/ren and to use the images for promotional or public use.